Hey all,

I posted most of this on facebook around Thanksgiving but people ask me every day about getting medical info online, so here’s my take, or at least part of it.

When I’m asked where to get good medical information online and unfortunately there is no good answer. Finding a doctor you trust is important if possible.

But you can do pretty well if you remain skeptical when reading science and medicine online. First, "legit" sites are often vetted better, but not always. Sites like Mayo Clinic and Cleveland Clinic have lots of good info but also lots of trash. Lots of the trash is usually related to supplements, diets, and other "faddish" stuff.

When reading medicine online, remember the adage "if it sounds too good to be true, it probably is.”

There are no magic pills or potions, no magic healing techniques, nothing "they" don't want you to know about. These sorts of claims have been around forever and have been BS for just as long.

In medicine we really do try to keep things simple. We can prevent heart attacks with diet, exercise, and simple, usually-inexpensive medications. There are no magic supplements or techniques hiding in plain sight. We've figured this out through rigorous science over decades. No one who is selling magic fairy dust at GNC is going to improve on this.

New discoveries happen all the time, but usually start with science done at the lab bench, then eventually in animals, then humans, and this research takes decades. Most ideas never pan out into anything useful. If you jump on the latest supplement or diet bandwagon, you have about a 1% chance of having chosen something useful. Because if it's too good to be true...

Always be skeptical and before you share some big new discovery on your socials, take a minute to try to find the source. Did it come from the mainstream media? Some meme on Tik Tok? A friend of a friend of a friend?

One thing we see often is some big new medical miracle, which, when traced back ends up being a press release from some company trying to raise capital for their next big project. Some news wire picks it up as fact, and then it spreads across the globe. And it was never more than a sales pitch. Don't share that.

People's stories of their medical journeys are important, but it's THEIR journey. You may be able to learn from it, and to practice empathy, but it doesn't necessarily apply to you. You don't have the whole story. You should neither judge nor try to apply someone else's experience without a good deal of research.

But what is "research"?

The colloquial meaning is, "I searched online to the best of my ability and tried to see what the truth is." That's a good start.

But this isn't the sort of research that normally leads you toward facts and truth. Human minds just aren't wired that way. That's why we invented science. In science, we try, to the best of our abilities, to assume that we are wrong.

Yes, wrong.

Let's say you want to do an experiment on the effect of exercise on memory. You're thinking, "exercise is probably good for memory," but when you design the experiment you start with the hypothesis, "Exercise has no effect on memory," and then collect data. If the data lead you to reject that, awesome. But in science, the starting point is, "My assumptions are probably wrong."

This helps prevent you from doing experiments designed to give you the answer you want. Don't do that. It's how our brains are wired and to get to the truth, you have to fight that, you have to not only know you may be wrong, but design your experiment around that assumption.

And that's how you should read medical info online--if it confirms your beliefs, immediately question it and look deeper because things that confirm our beliefs are easier to swallow, whether or not they're true.

Another thing that separates real scientific information from BS is that science knows that it might not be correct. It's designed that way. We always recognize that our conclusions could be proven false given enough contradictory information. But that doesn't mean that every conclusion is equally likely.

I often hear from antivaccination folks that "no one has proved that vaccines don't cause autism". That's because that's not what science does. First we look at the plausibility--is it conceivable that vaccines could cause autism, given what we know? The answer, based on our understanding of both immunology and autism, is that it's very unlikely. But that's different from impossible. So we’ve done a ton of studies looking at the question, assuming we could be wrong. And those data have shown, as conclusively as they can, that vaccination and autism are unrelated.

"So, Doc, what you're saying is you can't prove it!".

No, what I'm saying is that given what we know, it's vanishingly unlikely that there's a connection, just as it's vanishingly unlikely that you can throw a tennis ball in the air and have it not fall back to earth.

A common analogy is sunrise. Every day we see the sun rise in the east, and we infer that it will happen again, every time. We have all sorts of observations and science to support our conclusion, but we can never say that we are 100% certain the sun will rise in the east tomorrow--we can't "prove" it. There is a real but very, very small chance that we are wrong. And we have the additional background knowledge of why the sun rises in the east. Science helps us define the size of the chance that we are wrong.*

This has real world effects on you all the time. We get into a plane or drive over a bridge because scientists and engineers have designed these things to work. They can't "prove" gravity will always work, but it's very, very unlikely that our ideas of gravity are wrong.

So be skeptical, but not obstinately denialist. Don't reject an idea that doesn't confirm your assumptions, and don't swallow a story that does confirm your beliefs. Take a minute to dig a little bit deeper. Make sure that link to a new miracle supplement doesn't go straight to some influencer's tik tok and not further.

Digging a bit deeper, being a bit skeptical will help you find answers that are more likely to be true.

-pal

*My philosophy professor discussing inference used the example of the turkey and the farmer. The farmer comes every day and feeds the turkey. The turkey, missing the reason behind the observed behavior, infers that "farmer visit always equals food". Then Thanksgiving comes around...